Bloodwork and Treatment Plan

You guys already know this is gonna be long, sorry.
41 Male
5’ 8" 172#
High stress life or death job.
What is this sleep thing y’all keep talking about?
Diet- I try.
Bad Habits- I have them.

I have the whole LabCorp deal but hears what I think you want…
Testosterone, Serum: 665 ng/dL (264-916)
Free Testosterone: 9.0 pg/mL (6.8-21.5)
Dihydrotestosterone: 57 ng/dL (30-85)
Thyroxine (T4): 1.35 ng/dL (0.82-1.77)
DHEA-Sulfate: 354.0 (102.6-416.3)
TSH: 0.623 (0.450-4.500)
Luteinizing Hormone: 3.8 mIU/mL (1.7-8.6)
Prolactin: 7.0 ng/mL (4.0-15.2)
Prostate-Specific Ag, Serum: 0.5 ng/mL (0.0-4.0)
IGF-1: 100 ng/mL (75-216)
Estradiol, Sensitive: 21.2 pg/mL (8.0-35.0)
Triiodothyronine, Free: 3.9 pg/mL (2.0-4.4)
SHBG: 82.3 High nmol/L (16.5-55.9)


BEGIN T Cyp 200 mg/ml – 0.45 ml IM/SQ BIW

++ 27G, 5/8” needle/ 29G, 1/2" needle (1cc syringe Luer only)++

Patient prefers smaller needles

BEGIN HCG 400 iu SQ BIW to reverse/prevent testicular atrophy

BEGIN Anastrozole 0.125 mg BIW as needed per E2 symptoms (reviewed with Pt.)

BEGIN Zinc Picolinate 50mg One PO QD to reduce SHBG and E2/Raise DHT

BEGIN magnesium glycinate 400mg One QD to Decrease SHBG

BEGIN Boron 10mg QD to aid in Test levels and decrease SHBG

What do you think?
Seem like the right way to go?

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I can’t offer any commentary (I’m a relative novice), but it may be useful to edit in lab ranges just so we can see where you generally sit relative to the norm and so we don’t have to do any unit conversions.

That one i confused brother, you’re blood Result is IGF-1 100ng/mL of what scale what is the range of IGF-1 and was you in middle or higher end.

I think your starting dose is a little high and you may have issues with E2 spiking right after injections. You may want to start a little lower (80-100mg / week) and gradually increase after 6-8 weeks if needed.

Take heed to the “as needed” part.

Edit- I just noticed the BIW so I’m assuming that means bi-weekly. That’s a good starting dose, but if I’m correct on the bi-weekly you’re gonna feel like shit after about 8 days. E2 is gonna go in the tank. You have a recipe for a nice roller coaster ride there I believe.

Edit 2 (for clarity)- By E2 going in the tank, I mean that it’s going to spike with the large single dose, then you’re going to chase it with your AI, then it’s gonna go in the tank…ie roller coaster.

With a tt of 665 your going on trt? I’m assuming your free t is low due to shbg…

I agree but I’m starting to sound like a broken record, so I’m glad you said it this time! Lol

Me personally I would take the zinc and magnesium for a few weeks and then re evaluate.

His testicles are doing their job. Its possibly his liver that’s at fault???

Have you looked into nutrition in general? Also, maybe if your life is stressful, maybe you have a lot of cortisol in your system. That can work to counteract an otherwise healthy endocrinal system.

Edited the ranges. Sorry, thought those were standard.
Any and all help and advice is appreciated.

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The way I understand it, and I’m a simpleton, is that the high SGBG is robbing the testosterone.
They want me at a 1200-1400 Testosterone to counteract.
Well known clinic on here.

The LH score isn’t terrible and suggests testosterone production is decent, I hate it when a guy has a good HPTA that’s ruined by the liver over producing SHBG.

Some guys deplete their magnesium and pregnenolone when they begin TRT and it can cause bad anxiety.

Before TRT my TSH hovered around .5 and after I started TRT it increase to .90, you may also see an increase. Closer to 1.0 is best.

Can’t argue against it.
I punch that thing in face all the time.